Submit Your Health Clearance

As a health professional student, part of your training will include direct contact with patients. Indeed, this is an exciting time in your clinical training. It is your duty to protect yourself and others from communicable diseases. One of the University’s responsibilities is to provide an environment that minimizes your risk of contracting diseases that are preventable through vaccination. There are other engineering controls that are put in place to protect you and others, e.g. respirator fit testing, universal precautions.

Health Clearance Requirements

  1. Mandatory Health Requirements
  2. Official lab results documenting immunity to MMR, Hepatitis B, and Varicella.  We do not accept handwritten results.
  3. Be sure you have been screened for tuberculosis correctly!  You are required to have a Two Step PPD (2 skin tests within 7-21 days).  If you elect to test by blood or x-ray, you MUST submit the official lab result or x-ray report with your forms. We do not accept handwritten results.


It is the responsibility of the students to ensure that the health clearances are done well in advance of the time that they are needed. Do not wait until the last minute, because health clearances will typically require a tuberculosis test and other routine blood testing, and in some cases, urine drug testing. Please come in for these tests a week or two before your physical exam. Failure to present to the health center in advance may delay your ability to receive your health clearance. This will result in starting your clinical rotation late.

For your protection, a health clearance is required for every health science student. This health clearance is reviewed annually beginning with the year you begin any clinical rotation. Some of you begin your clinical rotations in your first year, others in your second year or third year. No student will be cleared for clinical rotations until all requirements are met.


When the health clearance requirements are met, you will receive a Health Clearance Certificate which is required before you begin a clinical rotation and it must be renewed annually.

Department-Level Health Clearances

If respirator fit testing is required, contact your department or the Howard University Employee Health Department and plan to obtain this service. Your academic Department should notify us at least one month in advance of your first clinical rotation. Check with your department for specific instructions for each rotation.

Health Professions students are enrolled in the following colleges:

  • College of Nursing and Allied Health Sciences
  • College of Dentistry
  • College of Medicine
  • College of Pharmacy

Email list of names for health clearance to

Your academic department should notify us at least one month in advance of your first clinical rotation. Check with your department for specific instructions for each rotation.

Two-Step PPD

Four-visit approach for two-step PPD (per CDC and Student Health recommendations)

Visit 1 Day 0 PPD antigen is applied under the skin
Visit 2 Day 2 or 3  Within 48-72 hours of placement If positive, it indicates exposure to the TB infection and a chest x-ray and further evaluation is necessary
Visit 3 Day 7-21 A second PPD skin test is applied for those with a negative first test
Visit 4 Within 48-72 hours after the second test was placed A positive 2nd test indicates TB infection in the distant past.  Chest x-ray and further evaluation will be necessary



An example of lab results with written annotations.

Titer and Vaccination Explanations – Qualitative vs. Quantitative 


Serum titers are blood tests that measure whether or not you are immune to a given disease. More specifically, a quantitative serum titer is a titer with a numerical value indicating your actual degree or immunity to a disease(s).

Those in the health sciences and working at clinical sites require documented proof of immunity in the form of quantitative titers. Simply getting the vaccination is not enough. Therefore, each student must have QUANTITATIVE titers drawn and keep copies of the official laboratory printouts containing the numerical values for Measles, Mumps, Rubella, Hepatitis B and Varicella immunity.

Avoid common pitfalls:

  1. If you do not have a record of the previous vaccinations you have received, get your titers drawn first. Why?
    • Your titers may indicate a high immunity to a specific disease.
    • If so, you may not need to get vaccinated for that disease.
  2. Please get the specific titers we require and they must be QUANTITATIVE.
    • Quantitative vs. Qualitative titers quantitative titers have a numerical value and qualitative titers simply indicate immune vs. non-immune with no numerical value.
    • If you do not submit quantitative titers, we will ask you to have them repeated.
    • IgG vs IgM you need IgG titers: DO NOT get labs for IgM titers.
    • HbsAB IgG vs. HbsAG IgG (for Hepatitis) you need HepB AB (antibody) titers, DO NOT get Hep B AG (antigen) titers.
  3. If the titer shows that you are non-immune or negative, you need to get vaccinated or re-vaccinated (booster shots) BEFORE you come to campus.
  4. Once vaccinated, titers should not be drawn until 6-8 weeks after the vaccination. Why?
    • If titers are drawn too soon after the vaccination, the results will indicate non-immunity.
    • Do not make the mistake of having the titer drawn too early.

If Your Quantitative Titers Come Back Non-Immune

  1. Consult your physician about your vaccination history. How many immunizations have you already received for the disease(s)?
  2. If you have not received the vaccine series, start it now for the non-immune disease. If you arein the middle, complete the series.
  3. If you have completed the series, you will need to have boosters for that disease.
  4. After completing the series, or getting the booster, wait 6-8 weeks to get a follow up titer. DO NOT GET THE TITER DRAWN TOO EARLY.

What if the Follow-up Titer Still Comes Back Non-Immune?

  1. If you have received all the immunizations possible (completed the series and gotten boosters) and you are still non-immune, you may not convert.
  2. Please contact your physician for next steps.